Abstract

OBJECTIVE:
To know, the earliest age to avoid surgical intervention in Congenital Dislocated Knee.
METHODS:
This Prospective study was carried at JPMC Karachi, Pakistan from January 2013 to December2016.The patients with Idiopathic, Type II & III Congenital Knee Dislocations, in newborn to three months were managed by serial manipulation and Casting with and without per cutaneous quadriceps Tenotomy.
RESULTS:
At 25.17 months follow-up 22 patients (31 Knees) out of 23 patients, behaved Excellent to good .Average 4 casts required, to achieve >1200 flexion, stable knees in 95.65% Knees. The number of casts increased from 3 in age group of one day to 5 casts in age group over one month, including 15.6% Per Cutaneous Tenotomies.
CONCLUSION:
The duration from birth to start of treatment is directly proportional to functional outcome. The CDK is easy to reduce without significant manipulation time, when treatment is started within 24 hours of birth. Manipulation takes more time and number of cast as age of initiating treatment increases from hour to four weeks. After four weeks age CDK often require an addition procedure of PCQT